15～24岁年轻男男性行为者性伴相处坚持自我及影响因素

目的了解年轻男男性行为者(young men who have sex with men, YMSM)性伴相处中坚持自我主张(简称坚持自我)现状,分析影响因素。方法 2015年9月-2017年6月以四川省绵阳市15～24岁YMSM为对象,用滚雪球抽样法招募调查对象,进行坚持自我、社会及性行为、心理健康等调查和血清学检测。结果共回收有效问卷349份,分别有76.2%能、20.6%一般、3.2%不能坚持自我。善沟通(35.2%)、自己强势(29.0%)是能坚持自我,依赖性(36.1%)、年龄小低自信(25.3%)是不能坚持自我主要原因。HIV阳性率在能、一般、不能坚持自我组分别为6.8%、11.1%、45.5%,呈上升趋势(χ~2_(趋势)=12.567,P<0.001)。多因素分析结果,年龄≥20岁、当地居住时间>1年、近6个月肛交有保护性其坚持自我可能性较大,自认艾滋病风险较小/很小、近6个月有偶然性行为、公园/浴室寻找性伴其坚持自我可能性较小(均P<0.05)。结论 YMSM坚持自我与人口学特征、社区融入、风险认识和性行为相关,坚持自我降低HIV感染风险。应提高YMSM行为自主性。

Self-adherence in the sexual partners relationship and its influencing factors among young men who have sex with men aged 15-24 years

Objective To investigate the status quo of self-assertion in the sexual partners relationship among young men who have sex with men (YMSM), and to analyze its influencing factors. Methods Snowball-rolling method was used to recruit YMSM aged 15-24 years in Mianyang City, Sichuan Province from September 2015 to June 2017 to serve as the surveyed subjects, and the contents of the investigation included self-assertion, social and sexual behavior and mental health. Serological examination was performed. Results A total of 349 valid questionnaires were recruited, and the proportions of YMSM with self-assertion, with self-assertion in general and without self-assertion were 76.2%, 20.6% and 3.2% respectively. Good communication (35.2%) and strong personality (29.0%) were the main reasons for self-assertion, while dependence (36.1%) and young age as well as low self-confidence (25.3%) were the main reasons for lacking of self-assertion. The positive rates of HIV in YMSM with self-assertion, with self-assertion in general and without self-assertion were 6.8%, 11.1% and 45.5% respectively, showing an upward tendency (χ²_tendency=12.567, P<0.001). Multivariable analysis showed that YMSM aged 20 years and above, YMSM with local residence time > 1 year and YMSM with protection measures at each anal intercourse in the past six months were more likely to insist on protecting themselves, while YMSM with self-recognition of the low/lowest risk of suffering from AIDS, YMSM with casual sex behavior in the past six months, and YMSM who looked for sexual partners in parks/bathrooms were less likely to adhere to protecting themselves (all P<0.05). Conclusions Self-assertion in YMSM is correlated with demographic characteristics, community integration, risk awareness and sexual behavior. Self-assertion reduces the risk of HIV infection; and hence, it is necessary to promote the behavioral autonomy among YMSM.